Provider Demographics
NPI:1730570912
Name:HOFFMAN, HEATHER L (CNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:LEINDECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:104 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:CAMP POINT
Mailing Address - State:IL
Mailing Address - Zip Code:62320-1314
Mailing Address - Country:US
Mailing Address - Phone:217-430-6776
Mailing Address - Fax:
Practice Address - Street 1:3800 E LAKE CTR
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62305-5839
Practice Address - Country:US
Practice Address - Phone:217-215-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277001955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400205918Medicare PIN